SEXUAL DYSFUNCTION FOLLOWING TRAM FLAP BREAST RECONSTRUCTION FOR BREAST-CANCER - A PRELIMINARY COMMUNICATION

Psychological and social problems have been documented as sequelae of mastectomy Patients may experience depression, anxiety, decreased sexu al interest, negative changes in body image, fears of recurrence and c oncerns regarding the mastectomy site or prosthesis. Immediate breast reconstruction using improved techniques such as the TRAM flap, have l essened the negative psychological impact of mastectomy but whether th ese procedures themselves result in psychologic or sexual impairment h as not been reported. We, therefore, report four patients, three of wh om were self-referred for psychiatric evaluation, who experienced chan ges in body image and sexual response after TRAM flap reconstruction. Although the TRAM flap procedure cannot be specifically implicated, th e similar presentation and complaints in these four cases suggest a po ssible association that warrants more rigorous study.